title: Analysis of clinical outcomes of linear vs. deep stop decompression from 3.5 to 6 atmospheres absolute (350 - 600 kpa) in awake rats.
abstract: Recreational divers are introducing "deep stops" at half the depth (HD-DS) to reduce the risk of spinal DCS with only Doppler evidence to support it. Therefore this research was designed to show the effect of an HD-DS on spinal DCS manifestations by evaluating whether: (1) air diving-induced spinal DCS could be produced in awake, freely moving rats at 3.5-6.0 atm abs (350-600 kPa); and (2) whether the introduction of an HD-DS reduced spinal DCS in such a model. Fifty-one female, Wistar rats (221 to 450 g) underwent one-hour compression at 350 to 600 kPa with seven minutes of decompression with/without a five-minute DS (HD-DS / No-DS). Animals were observed for three hours. Outcomes were classified as: (1) asymptomatic; (2) breathing difficulties; (3) paralysis/weakness; (4) immobility; or (5) death. Eight animals, exposed to 385 kPa air breathing for 60 minutes followed by a three-staged decompression of 7.5 minutes, remained asymptomatic. The profile is known to produce spinal DCS in anesthetized rats. Eleven animals were then used to determine the threshold for DCS: 500 kPa. A total of 14 animals were compressed to 550 kPa (Group 1). Group 1-A (n = 8) No-DS; Group 1-B (n = 6) HD-DS; 18 were compressed to 600 kPa (Group 2). Group 2-A (n = 8) No-DS; Group 2-B (n = 10) HD-DS.
  
  
  RESULTS
  (1) 385 kPa protocol did not produce visible DCS manifestations in awake rats. The binomial probability of no DCS in this sample size is 0.002818 for the proportion expected from a published report. The binomial probability of no fatalities is 0.005346). (2) No animals developed spinal DCS when assessed by visible paralysis/weakness or immobility, so no difference could be shown. Group 1-A: two deaths; two breathing abnormalities; four asymptomatic. Group 1-B: all asymptomatic. Difference recorded for breathing difficulties (p = 0.0483); none for fatalities (p = 0.2024). Group 2 mortality was 55% (n = 10). Group 2-A and 2-B: no difference for death (p = 0.6063) or breathing problems (p = 0.2084).
  
  
  CONCLUSIONS
  This model could not evaluate HD-DS for the prevention of spinal DCS in rats.
authors.affiliation: Division of Community Health, Department of Interdisciplinary Health Sciences, Faculty of Health Sciences, University of Stellenbosch, Stellenbosch, South Africa. fcronje@hbo.co.za
authors.forename: Frans J
authors.initials: FJ
authors.lastname: Cronjé
authors.forename: W A Jack
authors.initials: WA
authors.lastname: Meintjes
authors.forename: Peter B
authors.initials: PB
authors.lastname: Bennett
authors.forename: Surita
authors.initials: S
authors.lastname: Fitchat
authors.forename: Alessandro
authors.initials: A
authors.lastname: Marroni
authors.forename: Ole
authors.initials: O
authors.lastname: Hyldegaard
mesh_terms: D000818:Animals; D001274:Atmospheric Pressure; D003664:Decompression / Q000379:methods* / Q000401:mortality; D003665:Decompression Sickness / Q000517:prevention & control*; D004195:Disease Models, Animal; D004242:Diving / Q000502:physiology* / Q000639:trends; D005260:Female; D051381:Rats; D017208:Rats, Wistar; D013118:Spinal Cord Diseases / Q000517:prevention & control*; D014851:Wakefulness